scholarly journals P03.28 Structural characteristics in tumor and lymph nodes as predictors of 3-year metastasis-free survival in surgically treated NSCLC

2020 ◽  
Vol 8 (Suppl 2) ◽  
pp. A34.1-A34
Author(s):  
L Sellmer ◽  
J Kovacs ◽  
J Neumann ◽  
R Kiefl ◽  
D Kauffmann-Guerrero ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Structural Characteristics ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Physiological Role ◽  
Inclusion Criteria ◽  
Free Survival ◽  
Systemic Relapse ◽  
Patient Prognosis ◽  
Nsclc Patients

BackgroundSurgery is the treatment of choice for early and for some locally advanced non-small cell lung cancer (NSCLC). Ipsilateral hilar and mediastinal lymph nodes are generally removed at the time of tumor resection and assessed for tumor infiltration. However, in particular in the context of immunotherapy, there is now increased awareness about the physiological role of lymph nodes in cancer. It may be possible to assess immune response by examining the cellular composition of locoregional lymph nodes. We aimed to assess structural characteristics in tumor tissue and affected and unaffected lymph nodes in patients with and without 3-year metastasis-free survival.Materials and methodsInternal hospital databases were screened for NSCLC patients fulfilling inclusion criteria. Data on patients age, sex, surgery type, (neo)adjuvant therapy, tumor characteristics and time and location of relapse was extracted. FFPE tissue blocks of primary tumor, affected and unaffected lymph nodes were collected. Hematoxylin and eosin stainings were obtained and tissues were analyzed (e.g. for B-cell proliferation and macrophage infiltration) in collaboration with an experienced pathologist.ResultsA total of 754 NSCLC patients were screened for inclusion criteria. Of these, 71 patients remained in remission for at least 3 years after surgery, and 80 patients had local or systemic relapse within 3 years after surgery. Structural characteristics in tumor and lymph node immune populations differed between patients with and without 3-year metastasis-free survival.ConclusionStructural characteristics differ between patients with and without relapse. Our findings show that structural markers in tumor and lymph nodes should be taken into account when assessing patient prognosis and relapse risk.Disclosure InformationL. Sellmer: None. J. Kovacs: None. J. Neumann: None. R. Kiefl: None. D. Kauffmann-Guerrero: None. C. Schneider: None. A. Tufman: None.

scholarly journals P04.03 Expression profiles of immune markers as predictors of survival in surgically-treated NSCLC

2021 ◽  
Vol 9 (Suppl 1) ◽  
pp. A17.2-A17
Author(s):  
L Sellmer ◽  
J Kovács ◽  
J Kumbrink ◽  
J Neumann ◽  
J Walter ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Expression Profiles ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Free Survival ◽  
Immune Related Genes ◽  
Nsclc Patients ◽  
Disease Free

BackgroundSurgery is the treatment of choice for early and for some locally advanced non-small cell lung cancer (NSCLC). Ipsilateral hilar and mediastinal lymph nodes are generally removed at the time of tumor resection. There is now increased awareness about the physiological role of lymph nodes in cancer. We investigated the expression profiles of immune-related markers in matched tumor tissue, affected and unaffected N1 and N2 lymph nodes in patients with NSCLC and their relation to survival.Materials and MethodsInternal hospital databases were screened for surgically-treated NSCLC patients with documented relapse or long-term disease-free survival (defined as 3 years). Data on patients’ age, sex, surgery, (neo)adjuvant therapy, tumor characteristics and time and location of relapse was extracted. FFPE tissue blocks of primary tumor, affected and unaffected lymph nodes were collected. mRNA was extracted from these tissues and expression profiling of 751 immune-related genes was performed using the PanCancer IO 360 panel by NanoString Technologies. ResultsA total of 754 NSCLC patients were screened. Of these, 71 patients showed long-term disease-free survival and 80 patients had local or systemic relapse within 3 years after surgery. Expression profiles of immune-related genes in tumor and lymph node immune populations differed between patients with and without 3-year disease-free survival.ConclusionsExpression profiles of immune-related genes differ between patients with and without relapse. Our findings show that differences in expression profiles of immune-related genes in tumor and lymph nodes should be taken into account when assessing patient prognosis.Disclosure InformationL. Sellmer: None. J. Kovács: None. J. Kumbrink: None. J. Neumann: None. J. Walter: None. D. Kauffmann-Guerrero: None. C. Schneider: None. A. Tufman: None.

THE ROLE OF SURGICAL STAGE IN COMBINATION THERAPY FOR PATIENTS WITH LOCALLY ADVANCED CERVICAL CANCER

2019 ◽  
Vol 65 (5) ◽  
pp. 749-755
Author(s):  
D. Reyes Santyago ◽  
Anzhella Khadzhimba ◽  
M. Smirnova ◽  
Sergey Maksimov
Keyword(s):  
Cervical Cancer ◽  
Radiation Therapy ◽  
Combination Therapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Advanced Cervical Cancer ◽  
Relapse Free Survival ◽  
Regional Lymph Nodes ◽  
Free Survival ◽  
Locally Advanced Cervical Cancer

Objective: to justify the expediency of the surgical stage as a part of the combination treatment for stage IIA-IIIB cervical cancer. Materials and methods. The study included 343 women with stage IIA-IIIB cervical cancer treated from 2013 to 2016 with mandatory follow-up for at least 2 years. Patients were divided into 2 groups. The first group included 214 patients who received a combination treatment. At the first stage, neoadjuvant chemoradiation therapy was performed (remote radiation therapy 5 days a week with radio modification with Cisplatin once a week at a dose of 40 mg/m2). After evaluating the effect, patients were subjected to surgical treatment or continued chemoradiotherapy. The second group (n = 129) received standard combined radiation therapy. Various schemes of combination and complex treatment and standard combined radiation therapy were evaluated using the indices of general and relapse-free survival. Results. The proposed scheme for the combination therapy for patients with locally advanced cervical cancer showed significantly higher survival rates at all the analyzed stages. For the combined treatment group with complete cytoreduction, the two-year overall and relapse-free survival with stage IIA is 94.1% vs. 82.4%, with IIB 90.8% vs. 80.3%, with IIB 87.5% vs. 75%, with IIB with metastatic lesion of regional lymph nodes 85% vs. 70%. For the second group, two-year overall and relapse-free survival with stage IIA 75% vs. 50%, with IIB 70.9% vs. 56.3%, with IIB 59.1% vs. 40.9%, with IIB with metastatic lesion of regional lymph nodes 62.2% and 40.5%. The advantages of this approach are most clearly seen within patients with metastatic lesions of regional lymph nodes (85% vs. 62% accordingly). Conclusion. Cytoreductive surgery in combination with the combination therapy allows to achieve a significant increase in overall and relapse-free survival for patients with locally advanced cervical cancer compared with standard treatment programs.

Patterns of Care and Treatment Pathways for Non-Surgically Managed Early and Locally Advanced Non-Small Cell Lung Cancer Patients at Ain Shams University Clinical Oncology Department: a Retrospective and Descriptive Analysis

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Dr/Khaled Abdel Karim ◽  
Dr/Khaled Nagib ◽  
Dr/Ahmed Hassan Abd El Aziz ◽  
Christina Gamil Garas
Keyword(s):  
Overall Survival ◽  
Clinical Oncology ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Patterns Of Care ◽  
P Value ◽  
Treatment Pathways ◽  
Free Survival ◽  
Care And Treatment ◽  
Nsclc Patients

Abstract Background Lung cancer is the leading cause of cancer death worldwide, but little is known about how patients with this disease are managed. Aim of the Work We aim to study patterns of care and treatment pathways of non- surgically managed early and locally advanced NSCLC patients from January 2015 to December 2018 in Ain Shams University Clinical Oncology Department. Patients and Methods In this retrospective analysis we included patients the met the following criteria; age >18, histologically confirmed NSCLC patients whom didn’t undergo surgical resection with at least 6 months of follow up data. We collected data from Clinical Oncology department archive in Ain Shams university hospital. Our primary objective is to identify the patterns of care and treatment pathway for non surgically managed NSCLC patients in ASUCOD from January 2015 to December 2018. Results 86 patients finally met our inclusion criteria. Median age at diagnosis of 61 years with a range of (38-85), 95.3% were male. Most of the patients were stage III; 40.7% were stage IIIA, 41.9% were stage IIIB, and 9.3% were stage IIIC. 41 were treated radically, 37 received palliative treatment and only 8 patients received supportive care. Overall median progression free survival in our patients was 9.23 (7.4-13.5) and overall survival duration was13.4 (9.5-18.0). In radically treated patients, 68.3% received sequential chemoradiotherapy (sCRT), 29.2% received concurrent chemoradiotherapy (cCRT) or 2.4% received definitive radiotherapy alone (RT). In palliative treated patients, 73% received chemotherapy alone (CTX), 8.1% received palliative RT and 18.9% received both chemotherapy and palliative dose of radiotherapy (CRT). All treatment modalities were similar regarding median progression free survival and overall survival durations, 17.5 (3.6–19.6) and 20.6 (3.6–31.6) in cCRT, 17.5 (3.6–19.6) and 23.3 (17.7–31.2) in sCRT, 12.9 and 13.4 RT group, P value=0.57 and 0.16 receptively. Similarly, progression free survival and overall survival durations were 8.8 (3.0–15.8) and 16.2 (3.6–18.7) in CRT, 5.3 (0.4–7.6) and 8.6 (6.2–10.2) in CTX, 8.5 (0.4–8.5) and 8.5 (0.4–8.5) in palliative RT group, P value=0.64 and 0.15 receptively. In our study, first-line chemotherapy were Gemcitabine plus Cisplatin (41.9%) or Carboplatin (35.1%).The Second -line chemotherapy were Docetaxel (63.1%) or Paclitaxel plus Carboplatin (26.3%). Paclitaxel plus Carboplatin were the most regimen given with RT. Most of the patients received radiation dose of 60Gy/30Fr (73.2%). Regarding the incidence of toxicity, there were significant high rates of esophagitis in cCRT in grade 3 or more compared to sCRT. Conclusion We have found that less than half of this study population were treated radically while the other half received palliative treatment. And only few patients received best supportive care. Radically treated patients had higher progression free survival and overall survival durations compared to palliative and supportive treatment.

scholarly journals Immune signature driven by ADT-induced immune microenvironment remodeling in prostate cancer is correlated with recurrence-free survival and immune infiltration

2020 ◽  
Vol 11 (9) ◽  
Author(s):  
Xingbo Long ◽  
Huimin Hou ◽  
Xuan Wang ◽  
Shengjie Liu ◽  
Tongxiang Diao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Immune Cell ◽  
Locally Advanced ◽  
Underlying Mechanism ◽  
Immune Microenvironment ◽  
Hub Genes ◽  
Free Survival ◽  
Immune Signature ◽  
Immune Infiltration ◽  
Patient Prognosis

Abstract Androgen deprivation therapy (ADT) is a cornerstone treatment for locally advanced or metastatic prostate cancer (PCa). However, its potential effects on the tumor immune microenvironment (TIM) of PCa patients and the underlying mechanism remain largely unclear. To explore the effects of ADT on PCa TIM, RNA sequencing was performed on six paired pre-ADT biopsy and post-ADT PCa lesions, and five paired paracancerous benign tissues from patients receiving neoadjuvant ADT with locally advanced PCa. Bioinformatics methods including ESTIMATE and ssGSEA were used to evaluate the stromal immune score and immune cell infiltration in PCa and paracancerous tissues. Weighted correlation network analysis was used to screen hub genes in the ADT-induced immune remodeling process. The results showed differences exist between PCa and paracancerous tissues in response to ADT. Compared with paracancerous tissues, the immune remodeling effect of ADT in PCa was more intense. ZFP36, JUNB, and SOCS3 served as hub genes in the ADT-induced immune remodeling process and were associated with PSA recurrent-free survival in the TCGA and our neoadjuvant ADT cohort. To investigate the joint action of the above three hub genes, an immune signature score was constructed. The results showed that immune signature score-based immune subtypes reveal the heterogeneity of the immune microenvironment of PCa and showed significant differences in patient prognosis, tumor immune infiltration, mutation burden, and landscape.

scholarly journals The experience of treating locally advanced metastatic renal cell carcinoma with inoperable metastases to retroperitoneal lymph nodes

2013 ◽  
Vol 94 (4) ◽  
pp. 532-536
Author(s):  
F S Akhmetzyanov ◽  
M N Idrisov
Keyword(s):  
Renal Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Clinical Improvement ◽  
Metastatic Renal Cell Carcinoma ◽  
Primary Tumor ◽  
Renal Cell ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Metastatic Lymph Nodes

Aim. To list and review the combined treatment options in patients with locally advanced metastatic renal cell carcinoma with inoperable metastases to retroperitoneal lymph nodes based on the results of diagnosis and treatment of two patients. Methods. Patients underwent primary tumor resection with further immunotherapy in first case and further immunoradiotherapy in second case. Results. The results of locally advanced metastatic renal cell carcinoma successful treatment are presented. Patient U., aged 73 years was admitted to the oncology department with Karnofsky performance-status score of 50-60 points. The diagnosis of right kidney cancer was set up in 2008, but the patient has refused surgery. At the end of 2011 after general status worsening she was hospitalized for planned surgery. Upper and medium midline laparotomy was performed using the general anesthesia. Enlarged right kidney in retroperitoneum and a batch of paraaortic and paracaval metastatic lymph nodes 13-15 cm in diameter were found at revision, right kidney was substituted by tumor tissue with areas of normal kidney parenchyma at the upper kidney pole, the tumor diameter was 10 cm. Renal artery and vein were gradually separated out of lymph nodes batch with a lot of technical difficulties and stitched and tied up. The specimen was removed as a whole together with paranephric tissues. Post-surgical treatment was complicated by an endogenous intoxication. Immunotherapy with intramuscular oxodihydroacridinylacetate sodium 500 mg every 48 hours i/m could only be started in a month after the surgery. Nowadays the patient is alive and continuing the treatment with oxodihydroacridinylacetate sodium, that induced the clinical improvement and reduced the size of the rest of the affected lymph nodes. Patient K. aged 50 years was admitted by ambulance with the same diagnosis as the first patient, and was treated using the same principles with an addition of radiotherapy. The overall patient’s condition improved after the treatment, there was a reduction of low back pain intensity and reduction of paraaortic and paracaval metastatic lymph nodes aggregate on palpation. Conclusion. Primary tumor resection in presence of inoperable metastatic retroperitoneal lymph nodes with further immunotherapy and radiotherapy can lead to clinical improvement and increase of the patient’s life duration.

Tumor total lesion glycolysis and number of positive pelvic lymph nodes on pretreatment positron emission tomography/computed tomography (PET/CT) predict survival in patients with locally advanced cervical cancer

2020 ◽  
Vol 30 (11) ◽  
pp. 1705-1712
Author(s):  
Marjolein De Cuypere ◽  
Pierre Lovinfosse ◽  
Christine Gennigens ◽  
Johanne Hermesse ◽  
Ramon Rovira ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Total Lesion Glycolysis ◽  
Recurrence Free Survival ◽  
Advanced Cervical Cancer ◽  
Free Survival ◽  
Pelvic Lymph Nodes ◽  
Locally Advanced Cervical Cancer ◽  
Pet Ct

ObjectiveThe aim of this study was to investigate the prognostic value of metabolic parameters obtained at pretreatment [18F]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ([18F]FDG PET/CT) in patients with locally advanced cervical cancer. We hypothesize that these metabolic parameters could optimize the treatment decision and thus favor the outcome of patients suffering locally advanced cervical cancer.MethodsPatients with locally advanced cervical cancer underwent pretreatment PET/CT. Standard uptake values (maximum, mean, peak), metabolic tumor volume, and total lesion glycolysis were measured in the tumor and in the hypermetabolic pelvic lymph nodes. The relationship between clinical, pathological, and PET/CT metabolic parameters with recurrence-free survival and overall survival was assessed by Cox regression analysis.Results115 patients with a median age of 52 years (range 23–77) presented with locally advanced cervical cancer. After a mean follow-up of 33.0 months after initiation of therapy, 26 patients (22.6%) recurred of which 17 patients had distant metastasis; 18 (15.7%) patients died. Recurrence-free survival at 2 and 5 years was 79.2% and 72.2%, respectively. The total lesion glycolysis of the tumor and the delay between diagnosis and treatment were significantly associated with recurrence-free survival in the multivariate analysis (HR 1.00, p=0.004, and HR 2.04, p=0.02, respectively). Only the total lesion glycolysis of the tumor ≥373.54 (HR 2.49, 95% CI 1.15 to 5.38; p=0.02) remained significant after log rank testing. Overall survival at 2 and 5 years was 91.7% and 68.8%, respectively. The number of PET-positive pelvic lymph nodes was the only independent prognostic factor for overall survival in the multivariate analysis (HR 1.43, 95% CI 1.13 to 1.81; p=0.003).ConclusionTumor total lesion glycolysis and the number of positive pelvic lymph nodes on pretreatment PET/CT appear to be independent prognostic factors for recurrence and survival in patients with locally advanced cervical cancer. This may help to select patients who may benefit from therapeutic optimization and closer surveillance.

Initial reporting of NRG-LU001 (NCT02186847), randomized phase II trial of concurrent chemoradiotherapy (CRT) +/- metformin in locally advanced Non-Small Cell Lung Cancer (NSCLC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 8502-8502 ◽  
Author(s):  
Theodoros Tsakiridis ◽  
Chen Hu ◽  
Heath Devin Skinner ◽  
Rafael Santana-Davila ◽  
Bo Lu ◽  
...  
Keyword(s):  
Distant Metastasis ◽  
Locally Advanced ◽  
Progression Free Survival ◽  
Free Survival ◽  
Kaplan Meier ◽  
Randomized Phase Ii ◽  
Significant Difference ◽  
Clinical Models ◽  
Nsclc Patients ◽  
Clinical Trial Information

8502 Background: Metformin, a diabetes agent that inhibits mitochondria complex I, enhances radiotherapy and chemotherapy responses in pre-clinical models of NSCLC. NRG-LU001 examined whether metformin can improve outcomes of curative CRT in locally advanced (LA)-NSCLC. Methods: The primary endpoint of this trial was 1-year progression free survival (PFS). Unresected, non-diabetic, stage IIIA/B NSCLC patients were randomized (1:1) to either carboplatin-paclitaxel chemotherapy concurrent with chest RT (60Gy), followed by consolidation carboplatin-paclitaxel chemotherapy (Control Arm) or the same and oral metformin (2000mg daily) during cytotoxic therapy (Experimental Arm). PFS and overall survival (OS) were estimated with the Kaplan-Meier method; time to local-regional progression (TTLRP), time to distant metastasis (TTDM) were estimated using the cumulative incidence method. Adverse events (AEs) were graded with CTCAE v.4.0. Results: Between Aug.2014 and Dec.2016, 170 patients were accrued. Analysis was planned at 102 PFS events (Feb. 2019). There was no significant difference in rates or grade of toxicity between the two arms. 1- and 2-year PFS was 60.4% (95% CI: 48.5, 70.4) and 40.1% (95% CI: 29.0, 51.0) in Control vs 51.3% (95% CI: 39.8, 61.7) and 34.5% (95% CI: 24.2, 45.1) in the Metformin arm (multivariable Cox proportional HR=1.20 (95% CI: 0.81, 1.78), p=0.36). OS at 2 years was 65.4% (95% CI: 53.5, 75.0) for Control vs 64.9% (95% CI: 53.1, 74.5) for the Metformin arm (HR=1.03 (95% CI: 0.64, 1.68)), while deaths due to disease were 90% vs 71%, respectively. No significant differences were found for TTLRP or TTDM. Conclusions: NRG-LU001 center reported outcomes show that oral daily metformin was well-tolerated in combination with CRT treatment for LA-NSCLC. However, metformin did not improve PFS and OS and did not alter the rates of local-regional failure or distant metastasis. Acknowledgements: TT and HS are Co-Principal Investigators. This project was supported by National Cancer Institute (NCI) grants: U10CA180868 (NRG Oncology Operations), U10CA180822 (NRG SDMC), UG1CA189867 (NCORP), U24CA180803 (IROC). Clinical trial information: NCT02186847.

Recurrence-free survival analysis in locally advanced pheochromocytoma: first appraisal

2021 ◽  
Author(s):  
Sophie Moog ◽  
Frédéric Castinetti ◽  
Christine DoCao ◽  
Laurence Amar ◽  
Julien Hadoux ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Distant Metastasis ◽  
Tnm Classification ◽  
Locally Advanced ◽  
Recurrence Free Survival ◽  
Ki 67 ◽  
Multicentric Study ◽  
Free Survival ◽  
Catecholamine Excess

Abstract Context Locally advanced pheochromocytoma (LAP) behavior remains unknown. Objective To characterize this population and its recurrence-free survival (RFS). Design A retrospective multicentric study run within the ENDOCAN-COMETE network and GTE from 2003 to 2018. Setting 11 French Referral centers. Patients Patients with LAP as defined by capsular invasion, vascular invasion, adipose tissue invasion and/or positive locoregional lymph nodes at diagnosis without evidence of distant metastasis. Main outcome measures Recurrence was defined as the reappearance of the tumor, including local site and/or distant metastasis. The primary endpoint was RFS analysis. The secondary endpoints were characterization, overall survival (OS) and prognostic factors of recurrence. Results Among 950 patients, 90 exhibited LAP criteria (9%). 55 met the inclusion criteria (median age: 53 years-old, 61% males, 14% with a germline mutation, 84% with a catecholamine excess). LAP was defined by 31 (56%) capsular invasions, 27 (49%) fat invasions, 6 (11%) positive lymph nodes and 22 (40%) vascular invasions. After a median follow-up of 54 months (range, 6-180), 12 patients (22%) had recurrences and 3 (5%) died of a metastatic disease. Median RFS was 115 months (range, 6-168). The recurrences were local in 2 patients, distant in 2 and both local and distant in 8 patients. Median OS of patients was not reached. Size above 6.5cm (p=0.019) and Ki-67>2% (p=0.028) were identified as independent significant prognostic factors in multivariate analysis. Conclusions LAP represents 9% of pheochromocytoma’s population and is characterized by a metastatic behavior. This study paved the way of a future pathological TNM classification.

scholarly journals Adjuvant Radiation Therapy for Male Breast Cancer—A Rare Indication?

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3645
Author(s):  
Tobias Forster ◽  
Clara Köhler ◽  
Rami El Shafie ◽  
Fabian Weykamp ◽  
Laila König ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Locally Advanced ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Female Breast Cancer ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Disease Free

Due to its rarity, there are no randomized trials investigating the outcome of adjuvant radiotherapy in MBC. This study reports on patient and tumor characteristics of 41 consecutive MBC patients treated between 1990 and 2018 and on clinical outcomes after surgical resection of tumors and adjuvant radiotherapy of the chest wall or breast. Local control (LC), locoregional control (LRC), overall survival (OS), disease-free survival (DFS), and toxicity were evaluated. After a median follow-up of 80 months (95% CI: 14.6–213.8 months) there was only one recurrence, in a patient’s locoregional lymph nodes 17 months after start of radiotherapy, resulting in an LC rate of 100% at 5 years and a 5-year LRC rate of 97.4% (standard deviation (SD): 0.025). Five-year DFS and OS rates were 64.6% (SD: 0.085) and 57.2% (SD: 0.082), respectively. Adjuvant radiotherapy was tolerated well without high-grade (CTCAE grade > II) adverse events. After tumor resection and adjuvant radiotherapy, LC and LRC rates in MBC patients are excellent and comparable to results found for female breast cancer (FBC) patients. However, as patients are often diagnosed with locally advanced, higher-risk tumors, distant recurrences remain the major failure pattern.

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